Global and Regional Ventricular Repolarization Study by Body Surface Potential Mapping in Patients with Left Bundle‐Branch Block and Heart Failure Undergoing Cardiac Resynchronization Therapy

Douglas, Roberto; Samesima, Nelson; Filho, Martino Martinelli; Pedrosa, Anísio; Nishioka, Silvana; Pastore, Carlos Alberto

doi:10.1111/j.1542-474x.2012.00500.x

Cited by 8 publications

(4 citation statements)

References 24 publications

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“…15 references were excluded because no required data was available. Finally, 14 references ( 5 - 18 ) were accorded with the inclusion criteria of this meta-analysis ( Fig. 1 and Table 1 ).…”

Section: Resultsmentioning

confidence: 99%

Effect of cardiac resynchronization therapy on ventricular repolarization: A meta-analysis

Xu¹,

Gao²

2015

Anatol J Cardiol

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Objective:Cardiac resynchronization therapy (CRT) was thought to have a proarrhythmic effect on ventricular repolarization. But the results of previous studies were inconsistent. The aim of this study was to determine the effect of CRT on ventricular repolarization.Methods:A meta-analysis of studies focused on the effect of CRT on ventricular repolarization in patients undergoing CRT was conducted. Endpoints including QT interval (QT), JT interval (JT), QT dispersion(QTD) and interval between the peak to end of T wave (Tp-e).Results:A total of 14 studies were included in our meta-analysis. After pooling the data, no significant difference was observed in QT, JT and Tp-e between biventricular (BV) pacing and intrinsic ventricular rhythm. BV paced QTD was lower than intrinsic QTD, but the significance was ambiguous [mean difference (MD): -17.33, 95% CI -34.44 to -0.22, p=0.05]. Left ventricular (LV) paced Tp-e was significantly longer than intrinsic Tp-e (MD: 21.44, 95% CI 2.37 to 40.51, p=0.03). No significant difference was observed in QT, JT and QTD between LV pacing and intrinsic ventricular rhythm.Conclusion:In patients undergoing CRT, BV pacing has no deteriorating effect on ventricular repolarization, but LV pacing has a prolonging effect on Tp-e.

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Section: Resultsmentioning

confidence: 99%

Effect of cardiac resynchronization therapy on ventricular repolarization: A meta-analysis

Xu¹,

Gao²

2015

Anatol J Cardiol

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“…BSPM analysis has also been applied in several other research settings that all target electrical changes during complex cardiac disease. These examinations include the development of ventricular fibrillation, ideal parameters and device design for cardiac resynchronization therapies, better understanding the nuances of Brugada syndrome, and investigations into heterogeneity of repolarization times [164][165][166][167][168][169][170].…”

Section: Direct Interpretation Of Bsp Signalsmentioning

confidence: 99%

Body Surface Potential Mapping: Contemporary Applications and Future Perspectives

Bergquist

Rupp

Zenger

et al. 2021

Hearts

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Body surface potential mapping (BSPM) is a noninvasive modality to assess cardiac bioelectric activity with a rich history of practical applications for both research and clinical investigation. BSPM provides comprehensive acquisition of bioelectric signals across the entire thorax, allowing for more complex and extensive analysis than the standard electrocardiogram (ECG). Despite its advantages, BSPM is not a common clinical tool. BSPM does, however, serve as a valuable research tool and as an input for other modes of analysis such as electrocardiographic imaging and, more recently, machine learning and artificial intelligence. In this report, we examine contemporary uses of BSPM, and provide an assessment of its future prospects in both clinical and research environments. We assess the state of the art of BSPM implementations and explore modern applications of advanced modeling and statistical analysis of BSPM data. We predict that BSPM will continue to be a valuable research tool, and will find clinical utility at the intersection of computational modeling approaches and artificial intelligence.

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“…However, in spite of the clinical ubiquity of the 12-lead ECG in CRT patient care, its sensitivity to relevant electrophysiologic substrate behavior in that population is limited [3] , [4] . Recently, QRS complex features measured in multichannel electrocardiograms (i.e., ECGs from arrays with 50 to 250 electrodes [MECGs]) have been investigated to describe cardiac activation in CRT patients while addressing the spatial limitations of the 12-lead ECG and with the goal of concomitantly reducing patient non-response, which affects 30% of CRT recipients [5] – [8] . However, manual evaluation of the requisite QRS complex features would be prohibitively labor-intensive in MECGs and is not even routinely performed using 12-lead ECGs [9] – [11] .…”

Section: Introductionmentioning

confidence: 99%

QRS Complex Detection and Measurement Algorithms for Multichannel ECGs in Cardiac Resynchronization Therapy Patients

Curtin

Burns

Bank

et al. 2018

IEEE J. Transl. Eng. Health Med.

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We developed an automated approach for QRS complex detection and QRS duration (QRSd) measurement that can effectively analyze multichannel electrocardiograms (MECGs) acquired during abnormal conduction and pacing in heart failure and cardiac resynchronization therapy (CRT) patients to enable the use of MECGs to characterize cardiac activation in such patients. The algorithms use MECGs acquired with a custom 53-electrode investigational body surface mapping system and were validated using previously collected data from 58 CRT patients. An expert cohort analyzed the same data to determine algorithm accuracy and error. The algorithms: 1) detect QRS complexes; 2) identify complexes of the most prevalent morphology and morphologic outliers; and 3) determine the array-specific (i.e., anterior and posterior) and global QRS complex onsets, offsets, and durations for the detected complexes. The QRS complex detection algorithm had a positive predictivity and sensitivity of ≥96% for complex detection and classification. The absolute QRSd error was 17 ± 14 ms, or 12%, for array-specific QRSd and 12 ± 10 ms, or 8%, for global QRSd. The absolute global QRSd error (12 ms) was less than the interobserver variation in that measurement (15 ± 10 ms). The sensitivity, positive predictivity, and error of the algorithms were similar to the values reported for current state-of-the-art algorithms designed for and limited to simpler data sets and conduction patterns and within the variation found in clinical 12-lead ECG QRSd measurement techniques. These new algorithms permit accurate, real-time analysis of QRS complex features in MECGs in patients with conduction disorders and/or pacing.

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Global and Regional Ventricular Repolarization Study by Body Surface Potential Mapping in Patients with Left Bundle‐Branch Block and Heart Failure Undergoing Cardiac Resynchronization Therapy

Abstract: Ventricular repolarization parameters QTm, QTc(m), and QTD global/regional values, as assessed by BSPM, were reduced in patients under CRT with severe HF and LBBB. Greater recovery impairment in the Intermediate region was detected by the smaller variation of its dispersion.

Cited by 8 publications

References 24 publications

Effect of cardiac resynchronization therapy on ventricular repolarization: A meta-analysis

Effect of cardiac resynchronization therapy on ventricular repolarization: A meta-analysis

Body Surface Potential Mapping: Contemporary Applications and Future Perspectives

QRS Complex Detection and Measurement Algorithms for Multichannel ECGs in Cardiac Resynchronization Therapy Patients

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